How pain patients are treated like criminals

I no longer go to emergency rooms for help with any pain. They might fix my broken bone but then ask, “How many hospitals do you go to to try to get extra drugs?” One ER doctor told me to “go home and play your little drug games.”

Problem is, for every responsible narcotic user, you have another hundred who play the drug games.

Physician Coaching by KevinMD

How pain patients are treated like criminals 12 comments

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doc-AC

Being that this guy has chronic pain, and is such a responsible patient, he really shouldn’t be going to the ER in the first place.

I mean, seriously, why can’t this guy just make sure he has enough pills to start off with instead of blaming some tired ER doc when he comes into and EMERGENCY room with something that is not emergent.

I have great sympathy for people in pain, but maybe this guy is getting bad vibes not because he is requesting narcotic but because he is repeatedly presenting with the same bullshit over and over again. He should know to take pills at home, drink lots of fluids, and make an appointment with his MD.

SarahW

Did you read the article? You must not have. Because ER management of his chronic pain wasn’t really the issue. He doesn’t seek pain relief in the ER to manage his chronic pain.

The issue here seems to be disregard for the tolerance he has for narcotics as a result of treatment of a real, and painful, medical condition.

Forget the ER – this patient did not, despite providing documentation of his current treatment, get an adjusted dosage to provide pain relief following a PLANNED surgery while hospitalized, and the requests of his pain management physician to the physician who followed him in the hospital also were disrequarded.

He believes if he were to come into the ER with a broken bone, or other emergent condition, his need for adjusted dosage would not be accepted or acted upon.

scalpel

Unfortunately, many docs see giving out narcotics like passing out cookies at a party. If the kids are in line getting handed one cookie each, and the fat kid comes up and says “I want 8 cookies because that’s how many my mom gives me” how does the host react? Or “Hmmph….I don’t want plain old sugar cookies, I need the chocolate chip with macadamia nuts and little sprinkles. I’m allergic to sugar cookies.”

It isn’t correct to think that way, but deep down many of us do.

Medieval Medic

A couple of weeks ago, my wife sprained her ankle pretty bad at a public venue, and was carted off by ambulance.

She was offered IV MS no less than 10 times, between the paramedics and the ER doc(s). She’s mild-moderate fibromyalgic and has a rather unusual pain response.

They just could not understand that she wanted ibuprophen, not MS. I mean, she takes a daily dose of some decent drugs (Tramadol, anyone?) for her condition, so knows what does and does not work well for her. She said that she felt like they were trying to practically force the narcotics on her. Guess it takes all kinds.

That being said, they get points in my book for trying to take care of her pain, even though it was kind of over-kill in this case.

Criminallopath

So, any objective tests to measure the subjective complaints on the part of these “chronic pain” (one wonders if there is an organic basis for the conditions any of these complainers)patients yet? No.

Any objective diagnostic criteria or scientifically established organic basis for fibromyalgia yet? No. BTW, much thanks to the ACR for putting a name to the “fibrositis” of yore. For all of the scientific basis that allopathic medicine purports to have, some of what comes out of it is nothing more than the same type of quackery that one sees from chiropractic.

lawyersux

30% of all drug-related arrests in the Boston area are for prescrition drug sales. These “patients” obtain their drugs illicitly through physicians (often overcrowded ER’s) to re-sell them on the street. These patients NEVER leave without being seen when the ER wait is 12 hours, they see it as profiatble to wait. Meanwhile, ill patients sit in the waiting room. Almost EVERY DAY I see a patient who I have to wake up out of their Narcotic induced, pinpoint pupil coma, to ask them why they came to the ER, and I get “I fell and hurt my neck”. Most of these patients will not leave without security escorts and a threat to “sue you in Suffolk County Court”. Unless they’re completely ridiculous (ie known to have stolen narcotics from a dying relative in pain) I give them a script for 6 percocets so they won’t assault myself or the nurses.

scalpel

Why would you even consider giving them a schedule II drug? Are you really an MD?

Vicodin and OTD.

katy

The article you link to has been removed from the looks of it, so I can’t really comment on this person and this situation, but as someone who is on ongoing long-term opioid treatment, I can’t say I’d like being classified as a “narcotic-using pain patient”. I don’t “use narcotics”. People with major depressive disorder aren’t “antidepressent-using patients”, nor do they “use drugs”.

Language matters.

Anonymous

I have severe MS and thus am also accident prone as my hands do not hold things as well as they used to. I still continue to work every day. However, I had dropped a pretty big piece of equipment on my fingers and went to the ER. The doctor treated me like I was a total criminal. My fingers were swollen and I also had to have a work excuse to be off from work. He told me I was over-reacting and that I should have just ignored it. Needless to say, I had broken 2 fingers……he did not apologize or change his attitude. Having a disease like MS is hard enough..people scream at me with the handicapped tag I have, because they cannot see my “problem” and should save the spot for someone who is really sick, etc .

Dominique

I’m a college student in a college town in the middle of nowher Michigan and when I went in last year with a spastic gallbladder I was treated horribly and as if I was exhibiting drug seeking behavior until the doctor conformed the actual problem and then the whole experience changed. Its horrible they way some healthcare facilities treat pain patients.

Doctor Rocktor

To the author of this article, who publicly opined:

“Problem is, for every responsible narcotic user, you have another hundred who play the drug games.”

Does this statement have any basis in objectively measurable facts – or is it simply something to say in the hopes that a shoot-from-the-hip “mob mentality” will be unleashed in the comment section? I don’t see much evidence that such a mass lynching was the result …

On a lighter note – it reminds me of the old joke:
“99% of the lawyers are giving the other 1% a bad name!”

Thus, even “professionals” are not immune to talking themselves into disrepute if/when they entertain or engender unsubstantiated falsehoods in the course of “adversarial” endeavors …

Folks *expect* such adversarial modus operandi within our legal system – but … do they *deserve* the same from the modern-day “Apostles of Hippocrates”?

It would be interesting if you were to here post a response.
😉

.

Andy

Here’s a huge part of the problem: Folks like Lawyersux get a very skewed understanding of the opioid/pain management problem, because they see so many abusers at a collection point, if you will. Millions of Americans walk around in unnecessary pain and will seldom end up in the ER. There is also a strong Calvinist streak in this country: Pain good, pleasure bad. A great book deals with some of this– The Happiness Myth, by Jennifer Hecht.